Healthcare Provider Details

I. General information

NPI: 1184510901
Provider Name (Legal Business Name): WILLIAMS WELLCARE & PROTECTIVE PATHWAYS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 S GARNETT ST
HENDERSON NC
27536-4511
US

IV. Provider business mailing address

3117 CAMP RANGER LN
JAMESTOWN NC
27282-8687
US

V. Phone/Fax

Practice location:
  • Phone: 252-572-4112
  • Fax:
Mailing address:
  • Phone: 910-232-6290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP0904X
TaxonomyFederal Public Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA MURRILL WILLIAMS
Title or Position: ORGANIZER, NURSE PRACTITIONER
Credential: FNP
Phone: 910-232-6290